Robotic catheter system input device

ABSTRACT

An input device for a robotic medical system includes a handle configured to be rotatable about a center axis, and to be longitudinally displaceable along the center axis. The input device also includes a deflection control element disposed on the handle and configured to selectively control deflection of the distal end of a flexible medical instrument electrically coupled to the input device. Longitudinal displacement of the handle may cause or result in a corresponding longitudinal motion or deflection of the flexible medical instrument. Rotation of the handle may cause or result in a corresponding rotation of the deflection plane. Longitudinal displacement and rotation of the handle may be detected or sensed electronically.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of priority to U.S. provisionalapplication Nos. 61/040,141, filed Mar. 27, 2008; 61/040,142, filed Mar.27, 2008; 61/040,143, filed Mar. 27 2008; 61/099,904, filed Sep. 24,2008; and 61/141,971, filed Dec. 31, 2008, the entire disclosures ofwhich are hereby incorporated by reference as though fully set forthherein.

BACKGROUND OF THE INVENTION

a. Field of the Invention

The present invention relates to robotic catheter systems, and moreparticularly, to improved input devices for controlling movement ofcatheters and sheaths within a treatment area, such as a cardiacchamber. Input devices according to the present teachings may also beused with other computer-based medical systems, such as simulationsystems for training.

b. Background Art

Electrophysiology catheters are used for an ever-increasing number ofprocedures. For example, catheters have been used for diagnostic,therapeutic, mapping and ablative procedures, to name just a fewexamples. Typically, a catheter is manipulated through the patient'svasculature to an intended site, for example, a site within thepatient's heart, and carries one or more electrodes, which may be usedfor mapping, ablation, diagnosis, or other treatments.

Traditional techniques of manipulating catheters to, and within, atreatment area typically include a physician manipulating a handleconnected to a catheter. The handle generally includes a mechanismdirectly connected to guide wires for controlling the deflection of acatheter. A second handle is generally provided for controllingdeflection of a sheath. Rotating and advancing a catheter or sheathgenerally requires an electrophysiologist (EP) to physically rotate andadvance the associated handle.

Recently, catheter systems have been developed that work in concert withvisualization/mapping systems, such as the NavX™ or EnSite™ systemscommercialized by St. Jude Medical, Inc. However, conventional systemsstill generally involve an EP manually controlling a catheter and sheathsystem, and associated visualization systems typically reactivelymonitor catheter movement.

BRIEF SUMMARY OF THE INVENTION

Systems are provided for receiving user inputs and providing signalsrepresentative of the user inputs to a catheter system, which may be arobotic catheter system. An embodiment of a robotic catheter system(also referred to as “the system”) may be used, for example, tomanipulate the location and orientation of sheaths and catheters in aheart chamber or in another body portion. The system may incorporate ahuman input device, e.g., a joystick, configured for interaction with auser; an electronic control system that translates motion of the user atthe input device into a resulting movement of a catheter tip; and avisualization device that provides a user with real-time ornear-real-time positioning information concerning the catheter tip. Thesystem may provide the user with a similar type of control provided by aconventional manual system, and allow for repeatable, precise, anddynamic movements. The input system may thus provide a user, such as anelectrophysiologist, with an input device that mimics a device the useralready understands and is familiar with.

In an embodiment, the input device includes a first handle and a secondhandle. The first handle and the second handle may be aligned coaxiallyalong a shaft. The handles may include selector switches, dials orbuttons such as, for example, slider switches or thumb wheels, which maybe configured to control movement of the catheter and the sheath.Handles may be longitudinally displaceable along a shaft, and may beconfigured such that longitudinal displacement of a shaft results in alongitudinal displacement of the associated catheter/sheath. In anembodiment, the input device may include a single handle configured tocontrol the sheath and catheter, either together or independently. Inembodiments, the input device may include a selector mechanism, such asa three position switch, through which a user may selectively controlthe catheter, the sheath, or both the catheter and sheath.

In an embodiment, an input device may include one or more indicatorsconfigured to provide an indication to a user concerning whether acatheter, a sheath, or both a catheter and a sheath, are selected forcontrol. For example, input devices may include an LED indicator (e.g.,a white LED) to indicate a catheter is selected for control, and anotherLED (e.g., a blue LED) to indicate a sheath is selected for control.

In an embodiment, an input device may include a device control switchthat must be activated before the user input will transmit signalsindicative of user inputs. For example, a system in communication withan input device may be configured to accept inputs from user inputdevice only when a device control switch is activated.

A system according to the present teachings may be configured to receivethe inputs from the user input control, and to transmit the user inputsto a robotic catheter system configured to cause corresponding motion ofa catheter system.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is an isometric representation of a robotic catheter systemaccording to an embodiment.

FIG. 2 is an isometric view of an input device according to anembodiment.

FIGS. 3A-3D are several views of a handle for an input device accordingto an embodiment.

FIGS. 4A-4F are several views of a controller with an input deviceaccording to an embodiment.

FIG. 5 generally illustrates an input system according to an embodiment.

FIGS. 6A and 6B are isometric and side views, respectively, of an inputdevice according to an embodiment.

FIGS. 7A and 7B are side and isometric views, respectively, of anembodiment of a handle for an input device.

FIGS. 7C and 7D are side and isometric views, respectively, of anotherembodiment of a handle for an input device.

FIGS. 7E and 7F are side and isometric views, respectively, of yetanother embodiment of a handle for an input device.

FIGS. 7G-71 are side and isometric views of still another embodiment ofa handle for an input device.

FIGS. 8A and 8B are isometric views of an input device according to anembodiment.

FIG. 8C is an isometric view of a handle of input device, the handlebeing of the type generally illustrated in FIGS. 8A and 8B.

FIGS. 9A and 9B are views of an input device according to an embodiment,FIG. 9A being an isometric view and FIG. 9B being a side elevation view.

FIGS. 10A, 10B, and 10C are isometric views of an input device accordingto an embodiment.

FIG. 11A is an isometric view of an input device according to anembodiment.

FIG. 11B is an isometric view of a handle, the handle being of the typegenerally illustrated in FIG. 11A.

DETAILED DESCRIPTION OF THE INVENTION

Referring now to the drawings wherein like reference numerals are usedto identify like components in the various views, an embodiment of arobotic catheter system 10 (described in detail in co-pendingapplication titled “Robotic Catheter System” filed Sep. 24, 2008, herebyincorporated herein by reference in its entirety), also referred to as“the system,” is illustrated. The system 10 may be used, for example, tomanipulate the location and orientation of catheters and sheaths in atreatment area, such as within a heart chamber or another body cavity.As generally illustrated in FIG. 1, system 10 may include an inputcontrol system 100. Input control system 100 may include an inputdevice, such as a joystick, and related controls (further describedbelow), that a user such as an electrophysiologist (EP) may interactwith. Input control system 100 may be coupled to an electronic controlsystem 200 that translates motions of the user at or with respect to theinput device into a resulting movement of a catheter tip. Avisualization system 12 may provide a user with real-time ornear-real-time positioning information concerning the catheter tip. Thesystem 10 may further include a closed-loop feedback system 14, forexample, an EnSite NavX™ system, a magnetic positioning system, and/oroptical force transducers. The system 10 may additionally include arobotic catheter manipulator assembly 300 for operating a roboticcatheter device cartridge 400, and manipulator support structure 1100.The system 10 provides the user with a similar type of control providedby a conventional manual system, but allows for repeatable, precise, anddynamic movements. In an embodiment, certain elements described abovewith respect to system 10 may be omitted, or may be combined. Forexample, while electronic control system 200 is illustrated as astand-alone unit, it is understood that it may be incorporated intoanother device, such as manipulator support structure 1100.

Input control system 100 may permit a user to control the movement andadvancement of both a catheter and sheath. Generally, several types ofinput devices may be employed. The subject input devices of thisteaching include, without limitation, instrumented catheter handlecontrols which may comprise one or more joysticks generally resemblingtraditional catheter controls. In embodiments, for example and withoutlimitation, the input device may be self-centering, so that a movementfrom the center position causes an incremental movement of the actualcatheter tip. Alternatively, the input device may work in absoluteterms. Haptic feedback may also be employed in connection with the inputdevice or input control system 100 to provide a user with a physicalindication associated with contact (e.g., an indication when contact hasbeen made). By way of example, and without limitation, haptic feedbackmay include heating or cooling a handle of the input device (e.g., toprovide a user with an indication as to electrode temperature);vibrating a handle (e.g., to indicate contact with tissue); and/orproviding resistance to movement of the input device. In addition tobeing indicative of contact, haptic feedback may also be employed torepresent physical limitations of a device. For example, haptic feedbackmay be provided to indicate that a catheter or sheath has reached theend of available translation, achieved a maximum deflection, and/or toindicate another physical property of an associated medical device. Inan embodiment, vibrating a handle, or providing resistance to movement,may be implemented using one or more motors coupled or in operativecommunication with a handle.

Many additional features may be included with the system 10, which maybe used to help improve the accuracy and/or effectiveness of the system.Such features may include providing feedback using a visualizationsystem 12, employing a magnetic positioning system, (e.g., for creatingcardiac chamber geometries or models), displaying activation timing andvoltage data, etc. Such features may be useful to, e.g., identifyarrhythmias, guide precise movement of catheters or optical forcetransducers, etc. Additional features may include active tensioning of“passive” steering wires to reduce the system response time; cumulativeablation while an electrode tip is following a front-to-back ironingmotion; and/or reactive/resistive impedance monitoring.

System 10 may include visualization system 12 which may provide a userwith real-time or near-real-time positioning information concerning thecatheter tip. In an exemplary embodiment, system 12 may include amonitor 16 for displaying cardiac chamber geometries or models,displaying activation timing and voltage data to identify arrhythmias,and for facilitating guidance of catheter movement. A fluoroscopymonitor 18 may be provided for displaying a real-time x-ray image forassisting a physician with catheter movement. Additional exemplarydisplays may include an Intracardiac Echo (“ICE”) and EP Pruka displays,20, 22, respectively.

Referring further to FIG. 1, aspects of system 14 will be additionallydescribed.

System 14 (which may be of the type described in detail in U.S. Pat. No.7,263,397, titled “Method and Apparatus for Catheter Navigation andLocation and Mapping in the Heart,”) may be provided for creatingrealistic cardiac chamber geometries or models, displaying activationtiming and voltage data to identify arrhythmias, and guiding precisecatheter movement. System 14 may collect electrical data from catheters,may use this information to track or navigate catheter movement, and mayconstruct three-dimensional (3-D) models of the chamber.

As generally shown in FIG. 1, robotic catheter system 10 may include oneor more robotic catheter manipulator assemblies 300, for example, formanipulating catheter and sheath cartridges. Manipulator assembly 300may include interconnected/interlocking manipulation bases for catheterand sheath cartridges. Each interlocking base may be capable of travelin the longitudinal direction of the catheter/sheath. In an embodiment,longitudinal travel may include a translation of up to 8 linear inchesor more. Each interlocking base may be translated by a high precisiondrive mechanism. Such a drive mechanism may include, for example andwithout limitation, a motor driven lead screw or ball screw.

Robotic catheter manipulator assembly 300 may be usable with a roboticcatheter rotatable device cartridge. Manipulator base may be replacedwith a robotic catheter rotatable drive head and a robotic catheterrotatable drive mechanism.

As briefly discussed above, robotic catheter system 10 may include oneor more cartridges 400, with manipulator 300 including at least twocartridges, each of which may be configured to control the distalmovement of either the catheter or the sheath. With respect to acatheter cartridge, a catheter may be substantially connected or affixedto the cartridge, so that advancement of the cartridge correspondinglyadvances the catheter, and retraction of the cartridge retracts thecatheter. Each cartridge may, for example, include slider blocks rigidlyand independently coupled to one of a plurality of catheter steeringwires in a manner to permit independent tensioning of each steeringwire. The cartridge may be provided as a disposable item that is capableof being easily positioned (e.g., snapped) into place in an overallassembly. In an embodiment, the cartridge may include an electrical“handshake” device or component to allow the system 10 to properlyidentify the cartridge (e.g., by type and/or properplacement/positioning). A sheath cartridge may be designed in a similarmanner as the catheter cartridge, but may be configured to provide forthe passage of a catheter. The assembly may include a plurality (e.g.,as many as ten or more) of independent driving mechanisms (e.g. motordriven ball screws).

Robotic catheter system 10 may be useful for a variety of procedures andin connection with a variety of tools and/or catheters. Such toolsand/or catheters may include, without limitation, spiral catheters,ablation catheters, mapping catheters, balloon catheters, transseptalcatheters, needle/dilator tools, cutting tools, cauterizing tools,and/or gripping tools. The system 10 may additionally include a means ofidentifying the nature and/or type of catheter/tool cartridge that isinstalled for use, and/or position or connection related information. Itmay also be desirable for the system 10 to automatically access/obtainadditional information about the cartridge, such as, without limitation,its creation date, serial number, sterilization date, prior uses, etc.

FIG. 2 illustrates an embodiment of an input device 101. Input device101 may be configured to allow a user to selectively control a catheter,a sheath, or both a catheter and a sheath. Input device 101 may includeat least one handle 102 connected to a control box 104 via a spline 106.As described in further detail below, control box 104 may be configuredto receive inputs from a handle 102, such as user inputs from a usermanipulating handle 102. Control box 104 may translate received userinputs into outputs, such as electrical signals, which may be used by arobotic catheter system 10 to control, e.g., a sheath and/or a catheter.Control box 104 may include one or more switches 108. Switches 108 maybe configured to permit selection of one or more operating parameters,preset functions, or other functions such as: returning to a presetlocation, such as a home, or centered position; de-tensioning a catheteror sheath; reversing most recent movement; activating/deactivationablation energy, etc. Handle 102 may be configured for motion relativeto control box 104. In an embodiment, the motion of handle 102 relativeto control box 104 may be similar to the motion of a traditionalcatheter handle. For instance, handle 102 may be configured to rotate inthe direction R, and to be laterally displaceable, or translatable, inthe direction of arrow D. Handle 102 may include one or more switches,such as switches 110, 112, as will be described further below withreference to FIG. 3. Control box 104 may be configured to detect motionof handle 102, and to generate one or more electrical or control signalsin response thereto. The one or more control signals may be transmittedto robotic catheter system 10, such that manipulation of the handle 102results in movement of a catheter and/or sheath in a manner similar totraditional catheter systems.

FIG. 3A is an isometric view of a handle 102 according to an embodiment.Handle 102 includes a housing 118 comprising an upper portion 118A and alower portion 118B. Handle 102 also includes a slider switch 110. Sliderswitch 110 may be configured to be selectively displaceable from acenter position, generally in the direction of arrow D. In anotherembodiment, (not shown) slider switch 110 may be replaced with anotherswitch, such as a deflection dial rotatable with respect to the handle,a thumb wheel, a toggle switch, or any other appropriate switch. In anembodiment, slider switch 110 may be configured to provide inputrepresentative of a desired deflection of the tip of a catheter and/or asheath.

Handle 102 may also include a switch 112, which may, for example,comprise a three-position switch. Switch 112 may be configured toprovide an input representative of a desired control scheme. Forexample, switch 112 may have a first position wherein manipulation ofhandle 102 results in corresponding manipulation of a catheter. Switch112 may have a second position wherein manipulation of handle 102results in a corresponding manipulation of a sheath. Switch 112 may alsohave a third position wherein manipulation of handle 102 results in acorresponding manipulation of both a catheter and a sheath. Selectivecontrol, or individual control, of each of a catheter and a sheath maybe beneficial in that it may allow for compound movement and bending ofthe distal tip of the catheter and sheath. Combined control may bebeneficial when it is desired that the catheter and the sheath move, forexample, in a common direction, or along a common plane.

In the illustrated embodiment, upper portion 118A defines a plurality(in this case a pair) of apertures through which lights 116 may bevisible. Lights 116 may be, for example, light emitting diodes (LEDs). Afirst light 116A may be configured to illuminate when switch 112 ispositioned such that handle 102 controls a sheath. A second light 116Bmay be configured to illuminate when switch 112 is positioned such thathandle 102 controls a catheter. In an embodiment, lights 116A, 116B maybe configured to illuminate when switch 112 is positioned such thathandle 102 controls both a sheath and a catheter. Lights 116A, 116B maybe the same color, or may be different colors (e.g., colors associatedwith the components being controlled). As such, the use of differentcolor lights may be useful in providing a user with contrastingindications of devices selected for control.

Handle 102 may include another switch, such as button 114, which may beembedded in slider switch 110. Button 114 may be configured to provideone or more inputs to control box 104 during operation. In anembodiment, button 114 may be configured to act as a device controlswitch, such as a dead-man switch. For example, in such an embodiment,if button 114 is not depressed, manipulation of handle 102 will notresult in manipulation of an associated catheter or sheath. In anotherembodiment, button 114 may be configured to perform another function,such as providing an “on” signal for an associated ablation electrode.It is understood that handle 102 may also include one or more otherswitches (not pictured). A device control switch, or dead man switch,may also be implemented in another manner, such as by an optical relayor a capacitive switch which, when covered, indicates a user intends tomanipulate an associated catheter or sheath.

FIG. 3B is a partial exploded view of an embodiment of a handle 102 ofthe type generally illustrated in FIG. 3A. FIG. 3B illustratesembodiments of switches 110, 112, as well as lights 116A and 116B,mounted to lower portion 118B. Also illustrated is a bearing housing 120which may be configured to assist in displacement of control rod 130 (asgenerally described in further detail with respect to FIG. 4C).

FIG. 3C is a top view of an embodiment of handle 102 as generally shownin FIG. 3A generally illustrating switches 110, 112, as well as lights116A and 116B. FIG. 3D is a sectional view along line 3D-3D of FIG. 3C,further illustrating switch 110, as well as bearing housing 120. Bearinghousing 120 may define an aperture through which a control rod maytraverse (as generally described in further detail with respect to FIG.4C).

FIG. 4A is an isometric view of input device 101 such as shown in FIG. 2wherein the cover of control box 104 has been removed. FIG. 4A generallyillustrates handle 102 coupled with control box 104 by spline 106. Otherelements illustrated in FIG. 4A will be described in further detailbelow, with respect to FIGS. 4B and 4C.

FIG. 4B illustrates a top view of input device 101 of FIG. 4A, whereinswitches 108 have been removed. In the illustrated embodiment, inputdevice 101 includes a handle, such as handle 102 illustrated in FIGS.3A-3D, including switches 110, 112, and lights 116A, 116B coupled tohousing 118. Handle 102 is coupled to housing 104 through spline 106. Inan embodiment, spline 106 may be securely coupled to handle 102, suchthat manipulation of handle 102 induces a similar manipulation of spline106. For example, when handle 102 is rotated relative to control box104, spline 106 may rotate, transmitting the rotation to control box104. Similarly, when handle 102 is translated with respect to controlbox 104 (i.e., laterally advanced or retracted, in the direction ofarrow D), spline 106 may be similarly translated, thereby transmittingthe translation to control box 104. In another embodiment (notillustrated), spline 106 could be rigid, and handle 102 could beconfigured to rotate and translate with respect to spline 106. In suchan embodiment, handle 102 may include a rotary sensor and a translationsensor, wherein the rotary sensor could be configured to measurerotation of handle 102 with respect to spline 106, and the translationsensor could be configured to measure translation of handle 102 withrespect to spline 106.

Control box 104 generally includes a number of mechanisms configured toreceive inputs from handle 102 and to output those inputs as electricalsignals, or outputs. Accordingly, control box 104 generally includes arotation mechanism 122, a deflection mechanism 124, and a translationmechanism 126. Rotation mechanism 122 is configured to detect and/ormeasure rotational movement of handle 102. Deflection mechanism 124 isconfigured to detect and/or measure movement of slider switch 110.Translation mechanism 126 is configured to detect and/or measuretranslational movement of the handle 102. Control box 104 may alsoinclude an interface mechanism 128, which may be configured to transmitand/or receive one or more electrical signals, and/or to provide powerto one or more of rotation mechanism 122, deflection mechanism 124, andtranslation mechanism 126. In another embodiment (not illustrated),slider switch 110 could be replaced with a deflection dial configured torotate with respect to handle 102. A rotary potentiometer, or otherrotary sensor, could detect rotation of the dial and transmit a signalrepresentative of the rotation.

Referring now to FIGS. 4A-4F, input device 101 will be described infurther detail. As illustrated in FIG. 4C, spline 106 may be hollow,defining an aperture therein. A switch control rod (or simply “controlrod”) 130 may be coupled to slider switch 110 to translate motion ofslider switch 110 into control box 104. Control rod 130, which may be ahollow or a solid rod, may be configured to closely conform to an innerdiameter of spline 106, and bearing housing 120, to allow control rod130 to move within spline 106. Bearing housing 120 may include one ormore linear bearings disposed therein to facilitate displacement of thecontrol rod 130 within bearing housing 120.

Rotational mechanism 122, as shown in FIG. 4D, may be configured todetect and/or measure rotational movement of handle 102, for example, inthe direction denoted by arrow R. Rotational mechanism 122 generallyincludes a motor 132 and a rotational potentiometer 136 coupled tospline 106. Motor 132 may be coupled to rotational potentiometer 136.Rotational potentiometer 136 may be connected to a hub 137, which hub137 is connected to the spline 106, using a belt 134. Spline 106 may beconfigured such that rotation of spline 106 causes a correspondingrotation of rotational potentiometer 136, through the rotation of belt134. In an embodiment, spline 106, hub 137 and rotational potentiometer136 may be configured such that spline 106 may be displaced laterally(e.g., in the direction of arrow D) with respect to rotationalpotentiometer 136, independently of rotation of spline 106 androtational potentiometer 136. That is, spline 106 may be translated in adirection generally corresponding to arrow D without any substantialeffect on rotational potentiometer 136. In another embodiment (notpictured), rotational potentiometer 136 may be configured to bedisplaced laterally in a manner consistent with lateral displacement ofspline 106.

Motor 132 may be configured to rotate in response to a rotation ofspline 106. Rotation of motor 132 may be driven in a direct-drivemanner, without any intermediate gearing or reduction of power or speed.That is, rotation of motor 132 may be directly resultant from a rotationof spline 106. Alternatively, rotation of motor 132 may be indirect,such as through belt 134, rotational potentiometer 136, and/or hub 137.When rotated, rotational potentiometer 136 may be configured to transmita signal to, for example, a controller (not pictured) or an electronicinterface, such as interface mechanism 128. The controller, or interfacemechanism 128, may receive the signal from rotational potentiometer 136and may determine one or more properties of the rotation. For example,the angle of rotation may be determined based on the number of countsreceived by a controller, or a voltage change of a potentiometer, andthe speed of rotation could be determined by computing the timederivative of the calculated position.

In an embodiment, motor 132 may be configured to cause rotationalmovement of spline 106. For example, the system may include aself-centering feature, wherein spline 106, and handle 102, may returnto a home position, as if connected to a torsional spring. Motor 132 maybe configured to receive a signal from a controller, such as interfacemechanism 128, which may cause motor 132 to return spline 106 to thehome position.

Deflection mechanism 124, as generally illustrated in FIG. 4E, may beconfigured to detect and/or measure linear displacement of a switch,such as slider switch 110, in a direction such as corresponding to arrowD. As mentioned previously, slider switch 110 may be coupled to controlrod 130, which may translate lateral motion of slider switch 110 intocontrol box 104 through an aperture defined within spline 106. In anembodiment, control rod 130 may be coupled at a distal end to a linearpotentiometer 138A. Linear potentiometer 138A may be configured todetect and/or measure linear displacement of control rod 130, and thusmay detect and/or measure linear displacement of slider switch 110.Linear potentiometer 138A may be electrically connected to a controller(not shown) and/or may be connected to an interface, such as interfacemechanism 128. Linear potentiometer 138A may be configured to provide anoutput signal in response to linear motion of control rod 130, which maybe used by a controller, such as interface mechanism 128. The receivedsignal may be used to determine one or more of the speed, the direction,the force, and the magnitude of the displacement.

Translation mechanism 126, as generally illustrated in FIG. 4F, may beconfigured to detect and/or measure linear displacement of handle 102,in a direction such as corresponding to arrow D. In an embodiment,handle 102 may be coupled to a proximal end of spline 106. Spline 106may be coupled at a distal end to a linear potentiometer 138B. Linearpotentiometer 138B may be configured to detect and/or measure lineardisplacement of spline 106, and thus may detect and/or measure lineardisplacement of handle 102. Linear potentiometer 138B may beelectrically connected to a controller (not shown) and/or may beconnected to an interface, such as interface mechanism 128. Linearpotentiometer 138B may be configured to provide an output signal inresponse to linear motion of handle 102, which may be received by thecontroller, such as interface mechanism 128. The received signal may beused to determine one or more of the speed, the direction, the force,and the magnitude of the linear displacement of handle 102.

Deflection mechanism 124 and translation mechanism 126 may be mounted torespective bases, 140, 142. In an embodiment, deflection base 140 may beconfigured to interact with translation base 142, for example, asfurther described below. As illustrated in FIG. 4E, an embodiment of adeflection base 140 may include a deflection rail 144 along which adeflection body 146 may translate laterally. Deflection body 146 may becoupled to control rod 130, and to a plunger of linear potentiometer138A. Deflection body 146 may also be coupled to a belt clamp 148A,which is configured to be securely coupled to a belt 150A. When controlrod 130 is displaced, deflection body 146 may also be displaced, whichmay cause plunger of linear potentiometer 138A to be pushed into theouter cylinder of linear potentiometer 138A. Distal displacement ofcontrol rod 130, and the corresponding displacement of displacement body146 of deflection mechanism 124, may cause a rotation of belt 150A, asfurther described below.

In an embodiment, as illustrated in FIG. 4F, translation base 142 mayinclude a translation body 152 configured to translate along atranslation rail 154 in response to translation of handle 102.Translation rail 154 may be secured, for example, to a lower inner faceof control box 104. Translation body 152 may include a proximal riser156 configured to support spline 106. Riser 154 may support spline 106directly or, for example, using a rotatable hub 158. Rotatable hub 158may allow rotation of handle 102, and associated rotation of spline 106,to occur without imparting a significant torque on riser 156. Riser 156may also be coupled to the plunger of linear potentiometer 138B. Whenhandle 102 is translated, such as in a direction corresponding to arrowD, spline 106 may be similarly translated, which may impart a lateralforce on hub 158. The force on hub 158 may cause riser 156 to movelaterally, forcing the plunger of linear potentiometer 138B into thecylinder of linear potentiometer 138B. As riser 154 is translated,translation body 152 may move laterally along the rail 154. Translationbody 152 may also include a belt clamp 148B (not pictured) coupled to abelt 150B. Movement of translation body 152 may cause belt 150B to move.

As illustrated, for example, in FIGS. 4A-4F, deflection mechanism 124may be mounted on translation mechanism 126. In an embodiment,translation body 152 may include a groove 160 defined therein.Deflection rail 144 may be configured to be coupled in groove 160. Insuch an embodiment, linear potentiometer 138A may be coupled, at adistal end, to translation body 152. Deflection mechanism 124 may beconfigured such that linear displacement of translation mechanism 126,such as displacement along the direction of arrow D, will not affectdeflection mechanism 124. That is, the entire deflection mechanism 124may move laterally, resulting in no net change in the deflectionmechanism 124. Accordingly, deflection may be maintained withoutimpairing the ability to translate handle 102.

Each of the belts 150A, 150B may be configured to couple deflectionmechanism 124 and translation mechanism 126 to respective motors 162A,162B. In an embodiment, motors 162A, 162B may be coupled with anassociated controller, and/or may be connected to interface mechanism128. Motors 162A, 162B may transmit signals representative of motioninduced on the motor, such as by induction mechanism 124 or translationmechanism 126. Additionally, or alternatively, motors 162A and 162B maybe configured to induce motion of respective mechanisms 124, 126. Forexample, the system may be equipped with a self centering feature. Motor162A may be configured to receive signals from an interface, such asinterface mechanism 128, and to induce motion in deflection mechanism124 to return deflection mechanism 124 to an initial or a centeredstate. “Centered state” may refer to the geometric center of theavailable motion of the deflection slider switch 110. “Centered state”may, additionally or alternatively, refer to a preset position or stateprogrammable prior to, or during, a procedure. Similarly, motor 162B maybe configured to receive position signals, and to return translationmechanism 126, and the associated spline 106, to a centered state.

FIG. 5 generally illustrates an exemplary input system 100. Input system100 includes a computing system 102 configured to receive controlsignals from input device 101, and to display information related to theinput control system 100 on one or more displays 103. Displays 103 maybe configured to provide visual indications related to patient health,equipment status, catheter position, ablation related information, orother information related to catheter procedures. Computing system 102may be configured to receive signals from input device 101, and toprocess those signals. For example, computing system 102 may receivesignals indicative of a desired motion of a catheter within a patient,may format those signals, and transmit the signals to a manipulatorsystem, such as manipulator system 300. The manipulator system mayreceive the signals and cause a corresponding motion of the catheter.Position, location, and movement of an associated catheter or sheath maybe displayed to a user, such as an electrophysiologist, on display 103.The relationship between the movement of the input device 101 and anassociated catheter and/or sheath may be affected in part by one or morecontrol parameters or settings associated with computing system 102.Control parameters or settings may be provided by a user, such as an EP,through manipulation of software associated with computing device 102,through one or more inputs (e.g. inputs 108), or through otherconventional control means. Control parameters or settings may include,without limitation, scaling values which may affect the magnitude orvelocity at which the associated catheter or sheath is displaced inresponse to a given user input. For example, a scaling value of 2 mayresult in a catheter or sheath moving twice the distance that thecatheter or sheath would move with respect to a scaling value of 1.

FIG. 6A is an isometric view of an input device 101′ according to aanother embodiment. In the illustrated embodiment, input device 101′includes a first handle 102A and a second handle 102B. A first spline106A is illustrated extending through a proximal end of handle 102B, andis coupled with handle 102A. A second spline 106B is coupled to a distalend of handle 102B, and with control box 104′. Each of handles 110A and110B include a slider switch 112A, 112B.

In an embodiment, handle 102A may be configured to control a catheter,and handle 102B may be configured to control a sheath. In such anembodiment, handles 102A, 102B may be configured to move independently.Slider switch 110A may be configured to control deflection of anassociated catheter, and slider switch 110B may be configured to controldeflection of an associated sheath.

FIG. 6B is an isometric view of input device 101′ as generally shown inFIG. 6A, further illustrating the mechanisms housed within control box104′. Input device 101′ generally includes a first rotation mechanism122A, a first deflection mechanism 124 a, and a first translationmechanism 126A, as well as a second rotation mechanism 122B, a seconddeflection mechanism 124B, and a second translation mechanism 126B.Operation of the mechanisms may be similar to the operation described infurther detail above with respect to the foregoing drawings. Mechanisms122A, 124 a, and 126A are coupled with first handle 102A, and arerespectively configured to detect rotation, deflection, and translationof handle 102A, as well as to transmit signals representative thereof toan associated controller. Mechanisms 122B, 124B, and 126B, as similarlycoupled with second handle 102B, and are respectively configured todetect rotation, deflection, and translation of handle 102B, and totransmit signals representative thereof to an associated controller.

In an embodiment, handles, such as handle 102, 102A, 102B, may beconfigured to be removable and replaceable. For example, a first usermay prefer a handle 102 having a slider switch 110 to controldeflection. A second user may prefer a handle 102 having a dial switch(not pictured) to control deflection. A handle 102 may be configured tobe easily removed and replaced with a handle including varying methodsof providing input.

FIGS. 7A-7B illustrate an additional embodiment of a handle 102 for usewith an input device 101. Handle 102 includes a trigger switch 110 whichmay, for example, be configured to control the distal end of a medicaldevice, such as a catheter and/or a sheath. A switch 112 may beconfigured to allow a user to select one or both of a catheter andsheath for control. A rotation input 113 may be configured to allow auser to control rotation of an associated medical device, such as acatheter and/or sheath. In an embodiment, housing 118, which may includean upper housing 118A and lower housing 118B, and may be soft,contoured, or textured to allow for a more comfortable grip. Handle 102may be configured to allow a user to control translation of a catheterand/or sheath, such as by pushing or pulling handle 102 along spline106, generally in the direction of arrow D. Handle 102 may furtherinclude lights (not shown) to indicate the position of switch 112, whichmay provide an indication of one or more medical instruments selectedfor control.

FIGS. 7C and 7D illustrate another embodiment of a handle 102 for usewith an input device 101 (see, e.g., FIG. 2). Handle 102 includes arotary switch 110 which may be displaceable in the direction of arrow D.Switch 110 may be configured such that displacement of switch 110 in thedirection of the arrow D may control deflection of the distal end of anassociated medical device, such as a catheter and/or a sheath. Switch110 may be further configured such that rotation of switch 110 maycontrol rotation of a catheter and/or sheath. Handle 102 may include asecond switch 112, which may be a second rotary switch. Switch 112 maybe configured to allow a user to select one or both of a catheter andsheath for control. Housing 118, which may include an upper housing 118Aand a lower housing 118B, may be soft, contoured, and/or textured toallow for a more comfortable grip. Translation of a catheter and/orsheath may be controlled by pushing or pulling handle 102 along spline106, generally in the direction of arrow D. Rings of lights 116 may beprovided, and may be configured to indicate the position of switch 112,which may provide an indication of one or more associated medicalinstruments selected for control.

FIGS. 7E-7F generally illustrate another embodiment of a handle 102 foruse with an input device 101. Handle 102 may be configured such thatmoving handle 102 up or down, generally in the direction of arrow X, maycontrol deflection of the distal end of an associated medical device,such as a catheter and/or sheath. Handle 102 may include a switch 112which may allow selection of one or more associated medical devices,such as selection of one or both of a catheter and sheath, for control.Handle 102 may include a rotation input 113 which may be configured toallow a user to control rotation of a catheter and/or sheath. Housing118 may be soft, contoured, textured, etc., to provide a user with amore comfortable grip. Translation of a catheter and/or sheath may becontrolled by pushing or pulling handle 102 along spline 106, generallyin the direction of arrow D. Lights 116A, 116B may be used to indicatethe position of switch 112, which may provide an indication of one ormore medical instruments selected for control.

FIGS. 7G-7I illustrate yet another embodiment of a handle 102 for usewith an input device 101. Handle 102 may be configured such that movinghandle 102 up or down, generally in the direction of arrow X (FIG. 7G),may control translation of the distal end of an associated catheterand/or sheath. Handle 102 may be further configured such that movinghandle 102 to one side or the other, generally in the direction of arrowY (FIG. 7H), may control deflection of the distal end of an associatedcatheter and/or sheath. Handle 102 may be further configured such thatrotating handle 102, for example, in the direction of arrow R (FIG. 71),may control rotation of an associated catheter and/or sheath. Handle 102may include a selector switch 112 which may allow selection of one orboth of a catheter and sheath for control.

FIG. 8A generally illustrates an input device 101 including a handle 102which may be coupled to a control box 104 via spline 106. Handle 102 mayinclude a switch 110 which may be configured to control deflection of anassociated medical device, such as an associated catheter and/or sheath.Handle 102 may also include a toggle switch 112 which may be configuredto allow, e.g., selection of one or both of a catheter and sheath forcontrol. Handle 102 may further include a rotary switch 113 which may beconfigured to allow a user to control rotation of an associated catheterand/or sheath, such as by rotating switch 113 in the direction of arrowR. Handle 102 may further include a translation switch 115 which may beconfigured to control translation of an associated catheter and/orsheath. Housing 118 of handle 102 may include a contoured or texturedgrip, such as a silicone grip, for improved comfort. Control box 104 mayinclude a switch 114, which may be configured to serve as a dead manswitch. Control box 104 may also include one or more displays andindicators. For example, an acrylic display may be used to displayfunctions. One or more lights 116 may be provided and may be used toindicate the position of switch 112, which may provide an indication ofone or more medical instruments selected for control.

FIG. 8B generally illustrates another embodiment of an input device 101,similar to the input device of FIG. 8A. FIG. 8C is an enlarged view of ahandle 102 of the type shown in FIG. 8B. Handle 102 may be coupled to acontrol box 104 via spline 106. Spline 106 may be rigid, or may beflexible. Spline 106 may be configured to transmit one or moreelectrical signals between handle 102 and control box 104. Handle 102may include a trigger switch 110 which may be configured to controldeflection of an associated medical device, such as an associatedcatheter and/or sheath. The amount by which trigger switch 110 maytravel may be adjustable. Handle 102 may also include a toggle switch112 which may me configured to allow selection of one or both of acatheter and sheath for control. A rotary switch 113 may be configuredto control rotation of an associated catheter and/or sheath, such as byrotating switch 113 in the direction of arrow R. Handle 102 may furtherinclude a translation switch 115 which may be configured to controltranslation of, e.g., an associated catheter and/or sheath. Housing 118of handle 102 may include a textured grip, such as a silicone grip, forimproved comfort. Control box 104 may also include one or more displaysand indicators. For example, a display may be used to display functions.One or more lights 116 may be provided and may be configured to indicatethe position of switch 112, and thereby provide an indication of one ormore associated medical instruments selected for control. Control boxmay further include a holding rack 119, which may be retractable, may beconfigured, e.g., to hold handle 102 when handle 102 is not in use.

FIGS. 9A and 9B generally illustrate another embodiment of an inputdevice 101 including a handle 102 coupled to a control box 104 via aspline 106. Handle 102 may include a generally spherical switch 110.Switch 110 may be configured such that rotation of switch 110 may allowa user to control rotation of an associated medical device, such as acatheter and/or sheath. Handle 102 may also include, or be coupled with,a second rotary switch 113 which may be configured such that rotation ofswitch 113 may control deflection of the distal end of an associatedmedical device, such as, a catheter and/or sheath. Handle 102 mayinclude a toggle switch 112 which may be configured to allow a user toselect, e.g., one or both of an associated catheter and sheath forcontrol. Handle 102 may further include a switch 114 which may beconfigured to serve as a dead man switch 114.

Control box 104 may be coupled to a base 121 via one or more rotarycouplers 123. Rotary couplers 123 may be selectively adjustable to allowchanging of the angle of control box 104. Base 121 may include anemergency stop button 125, which may be configured to, e.g., retract anassociated medical device, such as a catheter and/or sheath, or toremove ablation energy from an ablation catheter. Base 121 may furtherinclude one or more switches 127, which may be selectively assignable bya user.

FIGS. 10A and 10B generally illustrates an embodiment of a handle 102for an input device. Handle 102 may be contoured, for example, toconform to the hand of a user. Handle 102 may be designed to conform toeither a right hand or a left hand. Input may be provided to an inputcontrol system 100, for example, using a trackball 129 and one or moreassignable buttons 131. Buttons 131 may be configured to allow a userto, e.g., select one or more of a catheter and sheath for control.Additionally, buttons 131 may be configured to allow a user to select afunction which may be controlled using trackball 129. For instance, afirst button 131A may be configured such that selection of button 131Acauses trackball 129 to control deflection of the distal end of anassociated catheter or sheath. A second button 131B may be configuredsuch that selection of button 131B allows trackball 129 to controltranslation of an associated catheter or sheath. Moreover, handle 102may be configured such that moving trackball 129 in a first direction,such as left or right, controls an associated catheter or sheath in afirst manner, such as by controlling deflection of the catheter orsheath, and movement of trackball 129 in a second direction, such asforward and backward, controls an associated catheter or sheath in asecond manner, such as by controlling translation. Handle 102 mayinclude one or more mounting holes to allow handle 102 to be mounted,for example, on a machine, a table, or to another medical device.

FIG. 11A generally illustrates a side isometric of an input device 101according to an embodiment. FIG. 11B generally illustrates an isometricview of a handle 102 which may be configured for use with input device101. Input device 101 may be a spatial input device, which may beconfigured to allow a user to move handle 102 in three dimensions.Handle 102 may be coupled to a control box 104 via a plurality ofcontrol arms 133. Control arms 133 may include several sections 135A-135d which may pivot and collectively allow movement of handle 102 in aspherical plane. While FIG. 11A illustrates two control arms 133, it isto be understood that input device 101 may include any number of controlarms 133. In an embodiment, input device 101 includes three control arms133. One or more of sections 135 may be coupled to one or more motors,sensors, or controllers, such as motor 141. Handle 102 may be coupled tocontrol arms 133 at a base 139, which may include one or more mountingpoints. Handle 102 may include a first rotary switch 110 which may beconfigured to allow a user to control an associated medical device, suchas an associated catheter and/or sheath. For example, movement of handle102 in the x-y plane may result in motion of the distal end of acatheter and/or sheath in the x-y plane. Movement of the handle 102 inthe z-plane may result in translation, or advancement, of the distal endof an associated catheter and/or sheath. Additionally, or alternatively,rotation of switch 110 may control deflection of the distal end of anassociated catheter and/or sheath. A toggle switch 112 may permitselection of one or both of a catheter and sheath for control.

Handle 102 may include a housing 118 coupled to the one or more controlarms 133 through a base 117. In one embodiment, housing 118 may berigidly coupled to base 117. In a further embodiment, housing 118 may berotatably coupled to base 117 through a rotary switch 113. Rotary switch113 may be configured to allow a user to control one or more propertiesof an associated medical device. For example, rotary switch 113 may beconfigured to allow a user to rotate the distal end of an associatedcatheter and/or sheath. Handle 102 may further be configured such thatthe angle at which housing 118 couples to base 117 may be adjustable.Handle 102 may further include a switch 114 which may be configured toserve as a dead man switch 114.

Input device 101 may be configured such that control arms 133, andassociated elements, may be configured to provide force feedback to auser. For example, motors, sensors, and/or controllers may be coupled toone or more of sections 135 of arms 133 to induce, assist or resistmotion in a particular direction. Multiple motors, sensors, controllers,etc., may work in concert to induce, assist, or resist motion in aspherical manner. Moreover, input device 101 may be configured such thatone or more of control arms 133, and/or one or more of sections 135, maybe selectively lockable. For example, motor 141 may selectively power,or lock one or more of motors 141 to restrict handle motion 102. In anembodiment, input device 101 may restrict handle 102 motion to aparticular plane, such as an x-y plane, or may, for example, preventmotion within the x-y plane while allowing handle 102 to translate androtate on an axis, such as the Z-axis. In another embodiment, inputdevice 101 may be configured to lock rotation along an axis, such as theZ-axis, while allowing handle 102 otherwise unrestricted movement.

Although embodiments of this invention have been described above with acertain degree of particularity, those skilled in the art could makenumerous alterations to the disclosed embodiments without departing fromthe spirit or scope of this invention. For example, while embodimentshave been described using potentiometers, it is to be understood thatadditional embodiment could include other types of sensors and encodersincluding, without limitation, absolute position encoders, relativeposition encoders, optical encoders, linear encoders, linear actuators,and linear variable differential transformers. All directionalreferences (e.g., upper, lower, upward, downward, left, right, leftward,rightward, top, bottom, above, below, vertical, horizontal, clockwise,and counterclockwise) are only used for identification purposes to aidthe reader's understanding of the present invention, and do not createlimitations, particularly as to the position, orientation, or use of theinvention. Joinder references (e.g., attached, coupled, connected, andthe like) are to be construed broadly and may include intermediatemembers between a connection of elements and relative movement betweenelements. As such, joinder references do not necessarily infer that twoelements are directly connected and in fixed relation to each other. Itis intended that all matter contained in the above description or shownin the accompanying drawings shall be interpreted as illustrative onlyand not limiting. Changes in detail or structure may be made withoutdeparting from the spirit of the invention as defined in the appendedclaims.

1. An input device for a robotic medical system including a medicalinstrument with a distal end, the input device comprising the following:a handle configured to be rotatable about an axis and to belongitudinally displaceable along the axis; a first sensor configured todetect axial rotation of the handle; a second sensor configured todetect longitudinal displacement of the handle along the axis; and adeflection control element disposed on or about the handle andconfigured to selectively control deflection of said distal end of saidmedical instrument within a deflection plane; wherein longitudinaldisplacement of the handle results in a corresponding longitudinalmotion of said medical instrument; rotation of the handle results in acorresponding rotation of the deflection plane; and the longitudinaldisplacement and rotation of the handle are detected electronically. 2.The input device of claim 1, wherein said medical instrument includes atleast one of a catheter and a sheath, and the input device includes aselection switch configured to permit selective control of the catheter,sheath, or catheter and sheath.
 3. The input device of claim 2, furthercomprising one or more indicators indicating whether the handle isconfigured to control the catheter, the sheath, or both the catheter andsheath.
 4. The input device of claim 1, wherein the input device isconfigured to return to an initial or centered position afterdisplacement.
 5. The input device of claim 1, further comprising atleast one sensor operatively connected or coupled to the handle, the atleast one sensor configured to detect at least one of displacement ofthe handle, rotation of the handle, and displacement of a switch.
 6. Theinput device of claim 5, further comprising a control system configuredto cause or result in a corresponding displacement of said medicalinstrument, wherein the at least one sensor is configured to provide asignal to said control system when the sensor is activated.
 7. The inputdevice of claim 6, wherein the velocity of the displacement of saidmedical instrument is proportional to the magnitude of the displacementof the at least one sensor.
 8. The input device of claim 5, wherein theat least one sensor is at least one of a potentiometer, a motor, and anencoder.
 9. The input device of claim 5, further comprising at least oneservo motor configured to return the handle to an initial or centeredposition after displacement.
 10. The input device of claim 9, whereinthe at least one servo motor is coupled to the handle in a direct-driveconfiguration.
 11. The input device of claim 1, further comprising adead man switch that is configured to prevent unintentional control ofsaid medical instrument.
 12. The input device of claim 11, wherein thedead man switch is an optical switch or a capacitive switch configuredto detect the presence or absence of a portion of a hand in contact withat least a portion of the handle.
 13. The input device of claim 1,wherein a first handle having a deflection control element of a firsttype may be selectively removed and replaced with a second handle havinga deflection control element of a second type.
 14. The input device ofclaim 1, further configured to provide haptic feedback to a user. 15.The input device of claim 14, wherein the input device is configured toprovide at least one of heat, cold, a vibration or a force to a userthrough the handle.
 16. The input device of claim 14, wherein hapticfeedback is indicative of contact of the distal of a catheter or sheathwith tissue within a treatment area.
 17. The input device of claim 14,wherein haptic feedback is indicative of a physical property of theinput device or an associated catheter or sheath.
 18. A device forcontrolling the robotic movement of a catheter, the device comprisingthe following: a joystick input device including a first sensorconfigured to detect motion in a first manner and a second sensorconfigured to detect motion in a second manner; and a control systemconfigured to receive a control signal from the first and second sensorsand to transmit a corresponding motion-related command to a cathetermanipulation mechanism; wherein the control system is configured torelate displacement of the joystick input device in the first manner toa corresponding advancement or retraction of at least one of a catheterand a sheath, and displacement of the joystick input device in thesecond manner to a corresponding deflection of the distal end of atleast one of a catheter and a sheath along a deflection plane.
 19. Thedevice of claim 18, further comprising at least one rotary input device,wherein activation of the rotary input device results in a correspondingrotation of the deflection plane.
 20. The device of claim 19, whereinrotation of the rotary input device results in a corresponding rotationof a distal end of at least one of a catheter and a sheath.
 21. Thedevice of claim 19, wherein the rotary input device is at least one of apotentiometer, a motor, and an encoder.
 22. The device of claim 18,wherein the first sensor and the second sensors each include at leastone of a potentiometer, a motor, and an encoder.
 23. The device of claim18, further comprising at least one centering mechanism configured toreturn the joystick input device to an initial or neutral position afterdisplacement.
 24. The device of claim 23, wherein the centeringmechanism includes at least one motor.